Pain in the Perineum: How Tecarthérapie Can Really Make a Difference

You’ve just given birth. You’ve been told it’s normal to be in pain. Yet every step hurts. Putting on underwear is a struggle. Sitting down to breastfeed becomes an ordeal. Later on, the thought of having sex makes your stomach knot up. It’s not all in your head. It’s your perineum that needs help.

Tecar therapy is a radiofrequency technique used in the clinic to soothe and eventually eliminate this pain, reduce swelling, and help the tissues heal. It is not a substitute for stitches or physical therapy. However, clinical trials in recent years have shown that it can provide relief much, much faster, thereby reducing the need for pain medication. Osteopathy, on the other hand, addresses everything surrounding the perineum: the pelvis, sacrum, coccyx, abdomen, and back. The two approaches complement each other. And it is often in the clinic that this combination truly comes into its own—which is why our clinics are now equipped with tecartherapy devices.

The perineum is the hammock of muscles and tissues between the pubic bone and the tailbone. During a vaginal delivery, it stretches to its limit. Sometimes it holds. Sometimes it tears. Sometimes an episiotomy is performed: a “small” incision to help the baby pass through.

Not all tears are the same. A superficial tear mainly affects the skin. A deeper tear reaches the muscles. The most serious tears affect the muscle that closes the anus. An episiotomy, on the other hand, is performed intentionally, but it is still a wound, with stitches, swelling, and a burning sensation at the slightest friction.

Even without a visible tear, the perineum can hurt. It has been compressed for hours. It’s swollen, tender, and sometimes feels like a raw blister. Saying you’re fine when every movement stirs up the area doesn’t help anyone, and all too often we forget that pain isn’t always visible.

In the very first few days, almost all women who have had an episiotomy or a tear experience pain. This isn't just a cold statistic—it's everyday life on the ward.

Some types of pain can be managed with pain relievers and a pillow. Others prevent you from living a normal life. Here is what many young mothers describe in very concrete terms—and this is neither rare nor an exaggeration:

Added to this are the dryness associated with breastfeeding, fatigue, and the fear of breaking something. The couple waits. The woman feels guilty. As for her body, it simply hasn’t finished healing yet.

These symptoms can occur with a tear, an episiotomy, and sometimes even with what is considered an “intact” perineum. The deeper the tear, the longer the pain tends to last. But the intensity of the pain isn’t a competition: if you can no longer wear underwear, if it hurts when you walk, or if you’re simply in pain, you have the right to be taken seriously.

Tecar therapy (also known as TECAR, or capacitive and resistive radiofrequency) delivers a high-frequency current to the tissues. It is not a hot plate placed on the skin. The energy stimulates the cells from within. A gentle warmth develops in the treated area, which most women find pleasant.

The practitioner uses two different techniques. One targets soft, water-rich tissues: muscles, blood vessels, and lymphatic vessels. The other targets firmer tissues: ligaments, fibrous areas, and scars that are beginning to tighten. On a freshly sutured perineum, caution is advised: short sessions, adjusted intensity, and never on an infection or a wound that is coming apart.

A session typically lasts between a quarter of an hour and twenty minutes. You feel a comfortable warmth—not like a sunburn. In trials conducted following childbirth, no adverse effects were reported. It is a completely painless—and even pleasant—treatment performed using medical equipment by a trained professional. At our clinics, we use the Winback machine, manufactured by a French company.

We're not going to tell you that science has proven everything. Here's what has been clearly established.

A French double-blind trial compared Tecar therapy to a placebo treatment on the day after and the day after that following childbirth in women who had experienced a tear or an episiotomy. Pain at rest was not significantly different between the two groups on the second day. However, the women who received treatment walked with less discomfort and took less acetaminophen. In other words: no miracle in terms of pain scores while lying in bed, but a real benefit in terms of mobility and reduced reliance on pain medication.

A larger trial, also comparing the treatment to a placebo, was published later. In that study, the reduction in pain at rest and while walking was more pronounced in the tecatherapy group. The same was true for discomfort while walking. The effect was evident as early as the first session. The women took fewer anti-inflammatory medications on the second day than on the first.

What should we take away from this, without overdoing it or underdoing it? Tecarthérapie primarily provides immediate relief: less tightness when walking, often a reduced need for pain medication, and relief that is sometimes felt right away. It does not heal a tear. It does not guarantee pain-free intercourse after one month: this aspect was not clearly demonstrated in the study that examined it. It is not the only effective treatment: applying cold in the first few hours, keeping the wound clean, managing loose stools, getting rest, and then physical therapy remain the foundation.

Other studies—on long-standing pelvic pain or scar tissue—support this conclusion: radiofrequency therapy can enhance rehabilitation, soften fibrous tissue, and reduce chronic pain, even years later.

You have a small tear, or it just hurts. Stitches aren’t always necessary. The area is still tender, though. Tecar therapy then targets the swelling, the burning sensation, and the difficulty sitting on a chair. We don’t wait for it to get worse before taking action.

You have a muscle tear or an episiotomy. This is the most commonly studied case for early Tecar therapy. The goal for the first few days: to walk over to the baby without feeling like the stitches are coming apart, to sit down to breastfeed, and to finally be able to wear loose-fitting underwear. Later on: to soften the scar so that it doesn’t remain like a tight cord under the skin.

You have a severe tear that involves the sphincter. The initial treatment is surgical and medical. Tecar therapy is not a treatment for incontinence. It may, at a later stage and following the medical team’s recommendation, help improve the comfort of the surrounding tissues. Urogynecological follow-up is not optional.

It’s been two months, six months, a year, or even years—and it still hurts. A tight scar, a burning sensation at the vaginal opening, a feeling of tightness, pain in the tailbone, or a stiff back whenever you lift the car seat: Tecar therapy at a clinic can help you significantly. Tecar therapy targets the fibrous tissue and works on overly tight muscles, while osteopathy helps restore movement to the pelvis and the rest of the body.

Here is what we can reasonably expect, based on what we know today and on what women describe after the sessions:

What we don’t promise: an invisible scar or the elimination of incontinence—but we’re here to offer you advice as well. Tecar therapy helps you feel better faster and is a great ally in the healing process.

Imagine a hammock suspended from four points: the pubic bone, the sitting bones, and the tailbone. During childbirth, these points shift. The sacrum moves backward. The pelvic bones spread apart. The tailbone can become trapped. The abdomen, still heavy, pulls. The back compensates. The perineum, even if properly sutured, remains attached to a framework that has not returned to its original position.

Focusing solely on the scar without looking at the bigger picture is like repairing the canvas without reattaching the hooks. That’s why osteopathy plays such an important role, and why we encourage you to come in for a consultation at our practice, rather than waiting for it to heal on its own.

Studies on postpartum osteopathy are particularly robust when it comes to the lower back and pelvic region: less pain and improved daily mobility after just a few sessions. As for the perineum itself, there are fewer large-scale trials. However, the clinical reasoning is crystal clear, and women often feel the difference right from the first consultation: the pelvis moves more freely, the tailbone no longer feels like a bone sticking out, walking becomes fluid again, and the scar feels less tight because the surrounding tissues have loosened.

At the office, the osteopath doesn’t just go over the details. He listens to your birth story (duration, forceps or vacuum extraction, epidural, position, tears, or episiotomy). He observes how you sit, how you breathe, and how you hold the baby. Then he works, using precise, gentle hands:

When tecarthérapie and osteopathy are combined, each does what it does best. The former warms, drains, and softens the local tissue. The latter realigns the pelvis so that this tissue no longer has to fend for itself. Next, perineal rehabilitation with a specialized physical therapist teaches the muscle to contract and relax at the right time. A muscle that is too painful or too tight cannot be trained properly. That is why it’s important to soothe and release tension before requiring the patient to perform exercises.

The right time? Often between three and six weeks after a vaginal delivery, a little later after a C-section, once the abdominal scar has healed. If you experience severe pain sooner (a stiff tailbone, inability to sit, or a feeling that something isn’t right), please let us know: an earlier appointment can, of course, be arranged. Conversely, it’s never too late—whether it’s three months, six months, two years, or even 10 years later.

Tecartherapy can be used as early as the day after birth, in a hospital setting, to treat tears and episiotomies. In a doctor’s office, it is also offered later on for closed scars, muscle tension, and persistent pain.

It is not recommended—or should only be used after consulting a doctor—in cases of fever, an open wound, infection, a suspected blood clot, a pacemaker, a serious illness currently being treated, or a keloid scar. Sudden pain, abnormal bleeding, an inability to urinate, or fecal leakage are medical emergencies.

If you’re breastfeeding, don’t worry!

You don't need to arrive prepared or have everything figured out. Just come as you are.

The goal isn’t to fill up a schedule. It’s so that you can put on underwear without wincing, walk with the stroller, sit down at the table, and—when you’re ready—rediscover intimacy without fear.

In the clinic, the osteopath works exclusively externally: using their hands on the pelvis, sacrum, coccyx, abdomen, and back—never internally. Neither the osteopath nor any other practitioner in the clinic performs vaginal or rectal examinations. In France, this procedure falls outside the legal scope of osteopathy. Your perineum can therefore be treated (Tecar therapy, work on the surrounding tissues, pelvic mobility) without any fingers being inserted. If an internal examination were deemed necessary, it would be performed by another qualified professional (midwife, physician, or specialized physical therapist), and we will refer you to a professional competent in this field. Even with this professional, any procedure will be performed only with your explicit consent.

The perineum is often overlooked. Women are told to wait until mandatory postpartum rehabilitation, as if the pain they’re experiencing today doesn’t matter. But pain that prevents a woman from getting dressed, sitting down, or even considering sexual intercourse is not just a minor postpartum issue. It’s a warning sign.

Tecar therapy provides proven relief, especially when walking and for comfort in the first few days, and is a valuable tool later on for tissues that are still tight. Osteopathy restores mobility to the pelvis. Together, in the clinic, they restore space to an area that has been put under significant strain by childbirth.

If your perineum feels like it’s on fire, if underwear has become the enemy, if sex is scary or painful, if your lower back or tailbone can’t take it anymore: make an appointment. Not to overdo it. But so your body can find a place where you can live comfortably—a place that’s yours.

Postpartum Tecatherapy and osteopathy, by appointment. Please remember to bring your birth report (type of tear or episiotomy, instruments used, and postpartum complications). Follow-up care is provided in coordination with your midwife and your pelvic floor physical therapist.